Since the discovery of the bactericidal activity of aminoglycosides, streptomycin, kanamycin, amikacin, and capreomycin (a macrocyclic peptide) have been widely used to treat tuberculosis and multidrug-resistant (MDR) tuberculosis. In general practice, resistance to kanamycin is often used as the sole criterion for defining extensively drug-resistant tuberculosis, assuming that all other drugs in this group or related drugs are resistant to certain strains. However, the assumption of cross-resistance between drugs in the same group is not always true for Mycobacterium tuberculosis. This prompted us to conduct a study to determine the concordance resistance pattern between aminoglycosides and the macrocyclic peptide capreomycin.A total of 2383 mycobacterial strains isolated from suspected MDR cases were subjected to susceptibility testing with aminoglycosides (kanamycin and amikacin), the polypeptide capreomycin, and ofloxacin to determine the resistance pattern. Cultures and susceptibility testing were performed using an automated BACTEC MGIT 960 instrument. Positive susceptibility samples were confirmed by PCR.The results showed that, of the total 2383 strains, 844 (35.41%) were susceptible to all four drugs, and 1539 (64.58%) strains showed resistance in the form of multi- or mono-resistance. The results also showed that of the 474 kanamycin-resistant mycobacterial strains, 86.7% and 77.6% were resistant to amikacin and capreomycin, respectively. Conversely, of the 425 amikacin-resistant mycobacterial strains, 3.3% were susceptible to kanamycin. Our findings suggest that performing susceptibility testing for individual drugs within a class may not provide an accurate strain status and may not be sufficient to make clinical decisions. It is necessary to conduct susceptibility testing of all MDR-TB strains with all aminoglycoside and macrocyclic peptide drugs before subjecting patients to comprehensive drug therapy.

Using satellite-based data, this study investigates the relationship between air pollution and plant health in Izmir province between 2020 and 2024. Air pollution was modeled with Nitrogen Dioxide (NO₂) and carbon Monoxide (CO) parameters derived from the Sentinel-5P satellite. At the same time, plant health was assessed using NDVI (Normalized Difference Vegetation Index) and NDMI (Normalized Difference Moisture Index) derived from Sentinel-2 satellite data. The data were processed on the Google Earth Engine (GEE) platform and interpreted through seasonal analysis. The findings revealed that NO₂ and CO concentrations increased in areas with high industrial and traffic density, which negatively impacted plant health. Especially the increase in NO₂ levels decreased the photosynthetic capacity of plants and increased moisture stress. There was a general decrease in NDVI and NDMI values in 2024 compared to 2020. This change was more pronounced in the winter months due to the impact of air pollution. Although the effects of CO levels on plant health were more limited, decreases in NDVI values were observed in high-traffic areas. As a result, it was emphasized that sustainable environmental policies should be implemented to reduce the negative impacts of air pollution on plant health. The research has shown that satellite-based technologies can be used as an effective tool in environmental monitoring processes and decision support systems.

This article presents a case of parapharyngeal pleomorphic adenoma, discussing its clinical manifestations, differential diagnosis, prognosis, and relevant literature. In the month of January in the year 2023, a female patient of age 61 was admitted into the hospital on account of suffering from cerebral infarction. During an MR examination, an incidental finding of a right parapharyngeal mass was noted, despite the absence of prominent symptoms. The tumor was surgically removed using a transcervical approach, and subsequent pathological analysis confirmed the diagnosis of pleomorphic adenoma.

Surgical Site Infections (SSIs) remains a significant burden on healthcare systems worldwide, contributing to increased morbidity, mortality and higher costs. This study evaluates the impact of Nurses’ compliance with an SSI prevention bundle and its impact on reducing the incidence of SSIs in a hospital setting, also providing insights into their compliance, perceived challenges, with the primary objective to assess the level of compliance of nurses to the Surgical Site Infection (SSI) bundle. Method includeddirect observation of nurses' adherence to the SSI bundle component and Pre-Designed questionnaire to assess nurses’ socio demographics, nurses’ compliance to SSI bundle and nurses’ understanding of impact to reduction of SSI .The study suggested a relatively high level of compliance but also highlights room for improvement.Logistic regression analysis identified compliance as a strong protective factor against SSIs .These results underscore the importance of adhering to evidence-based protocols to improve surgical site infections.Key barriers included time constraints due to heavy workload, inadequate training or knowledge on protocolsand poor communication with team.Strengthening adherence through education, resource allocation, and monitoring systems is essential to improve surgical outcomes. Nurses at Apollo, Secunderabad reported a strong level of knowledge, practice and compliance regarding adherence of SSI Bundle. Heavy workloads, Emergencies, Lack of inter team coordination at times lead to non-compliance of SSI bundle. A significant reduction of SSI due to higher compliance with SSI bundle through training, regular audits and feedback.

Background: A urinary tract infection (UTI) is an infection in any part of the urinary system. Use of Foleys catheter can also be one of the reasons for UTI. Urinary tract infections effect patient outcomes & cause huge financial burden on patient, his/her family as well as health care systems.1 CAUTI bundles were designed to decrease CAUTI and were proven to improve CAUTI rates when compliance percentage was high. Awareness of catheter associated urinary tract infection bundle by health care workers (HCWs) is essential for implementing CAUTI bundle which in turn prevent catheter associated urinary tract infections (CAUTI). There is a need to continuously train healthcare personnel about Foleys catheter care2. Lack of knowledge of bundle practices and its implementation has been implicated in increased CAUTI rates. Increase in CAUTI rates were observed as a trend in our institution. Hence, this study was taken to understand various reasons for the increase in the trend to take preventive and corrective measures. To reduce the catheter associated urinary tract infection rates and to increase the bundle compliance in intensive care units and wards, I have planned a structured, multidisciplinary training Programme on implementation of maintenance of bundle components, to create its awareness and its better implementation. CAUTI rates will be analysed post training Programme.3
Objectives: To assess the knowledge of staff nurses regarding prevention of Catheter Associated urinary tract infection, to evaluate the effectiveness of structured teaching program by comparing pre-test and post-test knowledge scores and to find the association between pre-test knowledge scores with selected demographic variables.
Aim: The aim of this study is to evaluate the effectiveness of a structured teaching program on enhancing the knowledge of staff nurses regarding the prevention of catheter-associated urinary tract infections (CAUTI) at Apollo Hospitals, Secunderabad. This will involve assessing the baseline knowledge of nurses before the teaching program and measuring any improvement in their understanding post-intervention, with a focus on preventive practices for CAUTI. This aim succinctly reflects the core objective of your study: evaluating the impact of a structured teaching program on knowledge improvement. Materials and Methods: This Hospital based prospective study was conducted in Apollo Secunderabad.
Study Design: This hospital-based prospective study was conducted at Apollo Hospitals, Secunderabad. A total of 100 staff nurses from various wards were selected to participate in this study.

Introduction: Most of the laboratory errors occur at the pre analytical phase (70%), emphasizing the need to acquire or apply more accurate method to solve and classify possible traps in this basic stage of the laboratory work1. Most of the problems in pre analytical phase is related to the factors (especially hemolysis) are associated with sample collection immediately. Causes of pre analytical hemolysis are associated with sample collection, inappropriate transportation methods, extreme temperature, sample handling, delayed processing and prolonged storage2. Hemolysis can notably effect the reliability of test. Vascular access devices such as catheters and needles may lead to cell lysis by exerting shear forces across the blood stream, Components from blood collection tubes such as stoppers, lubricants, surfactant and separating gels can leak into samples and / or adsorb analytes from the sample. Special tube additives can also change analytic stability. Due to these interactions with blood samples, blood collection sets are a potential source of pre analytical errors in laboratory tests2.Therefore, selection of device for blood collection becomes the most important consideration in optimizing the pre analytical phase and achieving consistent results. While the main determinants have preanalytical interchange ability, the blood collection technique has a significant impact on the reliability of laboratory test results. The butterfly collection set, which is a small needle attached to the elastic plastic wings and connected with an extension flexible tube, can be considered a reliable alternative to the classic straight needle for collecting blood in selected patient groups. In fact, an adapter can simply be attached so that it can fit into a vacuum needle holder and a vacuum system3.

Objectives: Choosing the right device for blood collection is an issue that is frequently encountered in laboratory. The purpose of this study was to compare the quality of the samples collected in terms of reduction in blood sample errors.

Materials and Methods: This Hospital based prospective study was conducted in Apollo BGS hospital Mysore. Blood samples were drawn from the 100 patients in ER and day care. A total of 100 patients and 156 blood samples were considered for the study.100 Patients who met the inclusion criteria were enrolled in the study.

Results: The total number of blood sample errors was decreased from 4% to 0.1%. There was significant reduction in blood sample errors. Significant difference was found out with respect to visual hemolysis and tube filling speed and pain intensity between the devices.

Conclusion:  our findings demonstrate that Therefore, selection of device for blood collection becomes the most important consideration in optimizing the pre analytical phase and achieving consistent results.

The temporomandibular joint (TMJ) is the only bilateral synovial joint in the body formed by the masticatory muscles, the mobile mandible, and the glenoid fossa and condyle of the temporal bone. Temporomandibular joint disorders (TMD) are a common type of musculoskeletal and neuromuscular disease. Due to the connection of myofascia and ligaments, the cranio-cervico-mandibular region forms a functional unit. The proprioceptive, pain, and other receptors on the deep fascia can complete a series of neural transmissions, and the muscles are activated by the central nervous system, thereby causing positional or shape changes in the connected bones. Under pathological conditions, different stimulating factors can be transmitted through the myofascia and bones, teeth within the cranio-cervico- mandibular region, leading to the appearance of clinical symptoms in the temporomandibular joint area and the neck. This review discusses the connection between the temporomandibular joint and the neck in terms of muscles, bones, and teeth in the head and neck region based on neural transmission, with the aim of providing new insights for the treatment and long-term management of temporomandibular joint disorders in clinical practice.

Autoimmune encephalitis (AE) is a group of disorders characterized by inflammation of the brain, often leading to neuropsychiatric symptoms. One of the most well-known forms is anti-N-Methyl-D-aspartate receptor (anti-NMDAR) encephalitis, which has a distinct clinical presentation and is often linked to an underlying tumor, most commonly an ovarian teratoma. The case discussed here presents a fascinating example of the management of anti-NMDAR encephalitis in a patient who also had an ovarian teratoma, highlighting the complexities in diagnosis, treatment, and long-term management1.
The patient, 14year-old female,a 14-year-old female patient visited to emergency department On 04-06-2023 with complaints of mild behavioral changes, noticed over 2 weeks. During examination patient was found with intermittent Confusional behavior but vitals were stable.  initially presented with psychiatric symptoms, including agitation, delusions, and memory impairment, progressing to seizures and motor abnormalities. Initial workup suggested the possibility of AE, which was confirmed through cerebrospinal fluid (CSF) analysis revealing anti-NMDAR antibodies. Imaging studies identified an ovarian teratoma, a well-known association with anti-NMDAR encephalitis. Prompt tumor resection, along with immunotherapy including steroids, intravenous immunoglobulin (IVIG), and rituximab, was initiated.
This case illustrates the importance of early diagnosis of anti-NMDAR encephalitis and its association with ovarian teratomas. The patient’s clinical course showed a favourable response to treatment, with gradual improvement in psychiatric and neurological symptoms post-surgery and immunotherapy. This case underscores the need for multidisciplinary collaboration between neurologists, oncologists, and immunologists in managing autoimmune encephalitis with an underlying tumor. The potential for full recovery with appropriate and timely intervention reinforces the importance of recognizing this condition early in clinical practice.

Background: NSIs are percutaneous injuries caused by needles or other sharp objects, resulting in potential exposure to blood borne pathogens. Needle stick injuries are significant occupational hazard for health care workers, posing a risk of blood borne pathogen transmission, including HIV, Hepatitis B, and Hepatitis C. According to the world Health Organisation (WHO), approximately 3 million health care Workers World-wide Experience NSIs each year, resulting in significant morbidity, mortality& economic burden. NSIs are more common among nurses, doctors, and other health care professionals who perform invasive procedures. The majority of NSIs occur during or after procedures, often due to improper needle handling, recapping, or disposal, by implementing safe needle handling & disposal practices NSIs ca ne prevented, encouraging reporting and documentation of NSIs. rushed or stressful work environment increase the likelihood of NSIs. NSIs affect approximately 10%to30% of health care workers, using needles with safety features such as self-sheathing or retractable needles. & educating healthcare workers on safe handling and disposal practices1.
Aim: To prevent NSIs from occurring in the first place, thereby reducing the risk of blood borne pathogen transmission and other complications. To determine the incidence of NSIs among Nursing staffs. To assess the knowledge, attitudes, and practices of nursing staff regarding NSI prevention and safety measures. & also ensuring accurate reporting & documentation of NSIs, facilitating investigation, analysis, & implementation of preventive measures
Materials and Methods: This hospital based prospective study was conducted in Apollo hospital Sheshadripuram. The 100staffs who met the inclusion criteria were enrolled in the study.
Results: The pre-test scores had a percentage of 77.4%, whereas the post-test scores reached 100%, suggesting that all participants achieved the highest possible score on the post-test. This improvement indicates a successful outcome and shows that the participants' knowledge or skills, as measured by the test, significantly increased.
Conclusion: In conclusion, the analysis of pre-test and post-test scores demonstrates a significant improvement in participants' performance. The mean pre-test score of 7.74 increased to a mean post-test score of 10, reflecting a substantial gain in knowledge or skills following the intervention. The increase from 77.4% on the pre-test to 100% on the post-test further emphasizes the effectiveness of the approach used in this study. This outcome suggests that the intervention or learning process had a positive and measurable impact on participants, leading to their full mastery of the tested material. The results provide strong evidence of the success of the program and its ability to enhance learning outcomes. Further studies could explore the long-term retention of the knowledge gained and the applicability of the intervention to broader contexts.

Purpose: Occlusal overload is a common causes of implant failure, resulting in pathological changes in the bone tissue surrounding the implant, primarily manifested as osteitis and direct bone resorption. This review aims to explore the molecular mechanisms of osteitis and bone resorption under overload conditions and their effects on implant stability. By examining the sequence of events in the development of osteitis and bone resorption, this paper intends to provide a deeper understanding of the pathological mechanisms induced by occlusal overload, offering a theoretical foundation for optimizing load management and controlling occlusal overload in clinical practice.
Study selection: This review examines the impact of occlusal overload on osteitis and bone resorption, with a focus on the underlying molecular mechanisms, drawing from clinical studies, animal models, and in vitro investigations.
Results: This review discusses how occlusal overload induces osteitis and direct bone resorption through different molecular mechanisms, influenced by the intensity of the applied load. Smaller forces typically lead to osteitis by promoting the release of damage-associated molecular patterns from damaged tissue cells, which activate Toll-like receptors, advanced glycation end products receptors, and others, initiating osteitis and subsequently bone resorption. Larger loads directly activate the bone resorption through signaling pathways like RANKL/RANK/OPG, Wnt/β-catenin, and others, which in turn trigger osteitis. Moreover, osteitis and bone resorption mutually reinforce each other, creating a vicious cycle that accelerates bone loss, ultimately compromising implant stability.
Conclusions: Different intensities of loading influence the progression of osteitis and bone resorption by activating specific signaling pathways.

Introduction: Hypertension is one of the most common lifestyle diseases affecting individuals globally. It is characterized by persistently elevated blood pressure levels, increasing the risk of severe cardiovascular complications such as heart attacks, strokes, and kidney diseases. Effective management strategies are crucial to prevent long-term health consequences. This study explores the classification, risk factors, diagnostic approaches, and treatment strategies for hypertension, with a particular focus on hypertensive crises.
Objectives:
-  To analyze the causes, classification, and pathophysiology of hypertension.   
-  To examine the impact of lifestyle modifications and pharmacological interventions in
   managing hypertension.   
-  To present a case study demonstrating the emergency management of hypertensive crises.
Methods: A comprehensive literature review was conducted, analyzing various research articles and clinical guidelines on hypertension. Additionally, a case study of a 65-year-old male patient with an acute hypertensive crisis was examined to illustrate real-world emergency
management. Data was collected through patient history, laboratory findings, and treatment responses.
Results: The study findings indicate that hypertension is influenced by genetic, lifestyle, and environmental     factors. Lifestyle changes such as dietary modifications, regular exercise, and stress management play a crucial role in controlling blood pressure. Pharmacological interventions, including diuretics, beta-blockers, and calcium channel blockers, are essential for long-term management. The case study analysis highlights the importance of timely medical intervention, adherence to medication, and continuous monitoring in preventing severe hypertensive complications.
Conclusion: Hypertension remains a significant global health concern, requiring a multi-faceted approach to management. Early diagnosis, lifestyle modifications, and proper medical interventions can reduce complications and improve patient outcomes. The case study underscores the need for emergency preparedness in hypertensive crises to prevent life-threatening conditions.